Laparoscopic surgical techniques have been introduced into China for nearly 25 years since the early 1990s. Laparoscopic surgical instruments have been developed with increasing ease, and the technology has evolved rapidly, with surgical procedures ranging from simple cholecystectomies to all general surgical procedures. In particular, the development and utilization of high-definition 2-D and 3-D laparoscopes as well as the da Vinci robot have made the use of laparoscopic surgery in general surgery virtually without contraindication. With the accumulation of experience and the maturation of technology, laparoscopic techniques have been applied to the treatment of hepatobiliary surgery with favorable results. The following highlights recent applications of laparoscopic techniques in hepatobiliary and pancreatic surgery. Laparoscopic application in liver surgery The liver is divided into 5 lobes and 8 segments, 1, 4a, 7, 8 segments are located deep in, or close to the first and second hepatic portals, if bleeding is often difficult to stop bleeding, so the laparoscopic liver surgery specification before 2012, laparoscopic liver surgery is only adapted to the edge of the liver irregularly resected, the rule of the liver, the left outer lobe of the liver resection or the left half of the liver resection. Laparoscopic hepatic resection was not indicated for segments 1, 4a, 7, and 8. In the past two years, with the exploration and accumulation of technology in various large domestic centers, laparoscopic liver surgery can be as perfect as open surgery in some cases; laparoscopic regular left hemihepatectomy and right hemihepatectomy, laparoscopic resection of segments 7 and 8, and even resection of segmental liver tumors of segment 1 can be accomplished totally laparoscopically. Recently, two centers in China have even carried out total laparoscopic two-step hepatic dissection of the right hemihepatic resection (ALPPS), which can be called the pinnacle of laparoscopic hepatic resection. Application of laparoscopy in biliary surgery Laparoscopic cholecystectomy has been widely performed, and district and county hospitals are familiar with its implementation, while some town-level hospitals also carry out laparoscopic cholecystectomy. In fact, laparoscopic cholecystectomy still carries a relatively high risk and must be performed by experienced laparoscopic surgeons. Since the bile ducts are up to 30% variable, an injury would be catastrophic; the patient may need to undergo multiple surgeries to achieve a better quality of life. Laparoscopic hepatic bile duct stone surgery is subdivided into extrahepatic and intrahepatic bile duct stones: intrahepatic bile duct stone surgery often requires resection of the affected liver lobe or segment, handling of the hepatic ducts of the liver section such as clearing the remnants of the stone and preventing bile leakage, and its surgical complexity tends to be more complicated than that of hepatic tumors, and the technical requirements are also higher. For extrahepatic bile duct stones it is necessary to incise the common bile duct and remove the stone either through a mesh basket or after lithotripsy with various instruments. It is necessary to have choledochoscope and lithotripsy equipment to carry out this type of surgery, so as not to encounter difficulties and have no choice. Therefore, only hospitals above the tertiary level are qualified to carry out this procedure, not only because of the complexity of the technology, but also because of the ease of injury to the bile ducts, bile duct stenosis, gallstones, bile leaks, infections, and other complications. Laparoscopy for biliary tract tumors is less frequently performed because the structure of hepatoportal is too complicated and lymph node dissection is difficult. A few centers try da Vinci robot to perform surgical treatment for gallbladder cancer and hepatoportal bile duct cancer. Application of laparoscopy in pancreatic surgery The pancreas is located in the retroperitoneal position, anterior to the spine, in an extremely deep position, closely related to the stomach, duodenum, bile ducts, jejunum, and mesenteric blood vessels, with complex reconstruction after resection and a high complication rate. Open surgery is still difficult, laparoscopic pancreatic surgery is difficult to imagine. Our medical experts started from the body-caudal tumor of the pancreas, and started with the body-caudal resection of the pancreas without preserving the spleen, then the body-caudal resection of the pancreas with preserving the spleen, and gradually transitioned to the pancreaticoduodenal resection, and went from laparoscopically-assisted open reconstruction to the total laparoscopic reconstruction. Such a procedure can only be performed by a very small number of pancreatic centers, the best of the best, in the country. Even then the right patients must be rigorously selected. Application of laparoscopy in cirrhotic portal hypertension Complications secondary to hypersplenism and rupture and bleeding of the esophagogastric fundic vein in patients with cirrhosis during the decompensated phase of liver cirrhosis, both of which now require surgical treatment, including resection of the giant spleen plus peripancreatic vascular dissection. Surgery is extremely risky due to poor liver function, coagulation disorders, recent history of bleeding, high variceal pressure, ascites, and poor systemic nutritional status in cirrhotic patients. A thorough preoperative examination and comprehensive adjustments must be made, followed by a systematic evaluation to rule out contraindications to surgery. The mortality rate of this type of surgery open surgery is 1-5%, and the difficulty and risk of surgery is extremely high. Only extensive surgical experience in weaning and shunting of open cirrhotic portal hypertension plus skillful laparoscopic surgical techniques can be attempted, otherwise it is a sign of irresponsibility. To summarize, laparoscopy has a broad application prospect in hepatobiliary surgery, which can only be carried out in some large hospitals (except for laparoscopic cholecystectomy) due to the complexity of the disease, the difficulty of surgical operation, and the high technical requirements for doctors. Our hospital has carried out laparoscopic liver, gallbladder, pancreas and spleen surgeries (except pancreaticoduodenectomy), and has achieved good results and accumulated rich experience. At the same time, laparoscopic biliary lithotripsy has been carried out to treat some patients with functional gallbladder, and hepatobiliary and pancreatic patients are welcome to consult with us.